(3 years, 1 month ago)
Commons ChamberThe hon. Lady first talked about the importance of border control, and she was right to do so. That is why the Government have already put in place the so-called traffic light system, with this Department working across Government with the Home Office, Border Force, the Department for Transport and others. The system absolutely needs to be kept under review to ensure that it is doing its job in protecting the people of this country from viruses, and especially from any new variants of covid-19 that may emerge. I can give her reassurance on that.
The hon. Lady also raised Test and Trace. She should know that the NHS Test and Trace system is the largest diagnostic exercise of its kind in British history. We have carried out more than 200 million tests, identified more than 4 million positive cases and found more than 7 million of their contacts. Every time that happens, whether in England, Scotland or any part of the United Kingdom, that breaks the chain of transmission and saves lives.
May I say how delighted I am to see my right hon. Friend back on the Front Bench? I congratulate him on his appointment to this crucial role, and I welcome his approach, as set out in his statement. He will be an excellent Health Secretary.
Can my right hon. Friend confirm that 19 July will mark the end of the road map out of lockdown, that “terminus” means the end of the line, not an interchange, and that it is his intention that all restrictions will be lifted on that date?
I thank my hon. Friend for her kind remarks. As she will have heard in my statement, it is absolutely our intention to have step 4 commence on 19 July and to remove restrictions and start returning to normal. She asked me specifically about all restrictions, or which restrictions. It is certainly our intention to remove restrictions, but as we follow the data in the coming days, we will set out more in due course.
(3 years, 8 months ago)
Commons ChamberI hope the hon. Lady will not mind my mentioning it, but I know that she is about to become a grandmother herself soon, so I understand the reason for her questioning. She raises a very important point. I know she is aware, because I believe we have had this conversation, that we are focusing on women in the Department at the moment, and of course the mental health of women is a big part of that. The post-natal depression services that have been rolled out across the UK in the past 18 months are a testament to the fact that we are focusing on mental health. I take her point on board, and she has made it before.
I very much thank the Minister for coming to the House so promptly and making this statement, and for her commitment to patient safety. I also pay particular tribute to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for initiating this very important review. Without that, we would not be here today.
The findings of the report are deeply harrowing. The scale of the deaths and injuries suffered are horrific, but so too was the response of the trust at the time. The report details this. Women at their most vulnerable could not get their voices heard. They were not listened to by those in positions of power, who normalised poor maternity care and also denied its existence. Instead of humility and empathy, what we saw was the harshness of bureaucratic defensiveness, with women at times “blamed for their loss”—that is in the report.
There is now a criminal investigation into this matter, but I would be grateful if the Minister would please ensure that nothing gets in the way of implementing the recommendations as soon as possible, so that families can see real change in maternity care, at this trust and also right across the country.
I thank my hon. Friend for her pursuance, her persistence and her dedication, both to her constituents and the hospital as a trust. I would also like to mention, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt) did, the parents of Kate Stanton-Davies and Pippa Griffiths, who have been instrumental in getting us along the pathway to where we are today. Yes, my right hon. Friend commissioned the report, I pushed for it to happen now, and my hon. Friend has been pushing also, but it is down to those parents and their commitment. It should not have to be like this. Parents should not have to go through what they have gone through to get to where we are today.
As my hon. Friend is aware, I have visited the trust myself and have been round the midwifery unit and the consultant-led unit, and I think there is an anomaly there. Should we have a midwifery unit and a consultants’ unit? Is that not where the problem is, with two separate disciplines not working together? Should there not be just one delivery unit? Does the culture not start there, and should we not look at how it works?
However, my hon. Friend has my absolute 100% assurance that, for as long as I am in this post, I will be driving forward the recommendations and findings of this report.
(3 years, 11 months ago)
Commons ChamberIt is a pleasure to follow the hon. Member for Wallasey (Ms Eagle), who made useful points as to how we, as a House, may scrutinise and be involved better in some of the decision-making process.
I am grateful for the opportunity to debate this subject today—it is the first such occasion. Let me start by thanking everyone who has worked so hard, not just people on the frontline, but Ministers, to try to grapple with this awful virus. I do not envy them the burden of their responsibilities, and I know they are doing their very best at this difficult time and that not all will go well first time around. They deserve our thanks, from across this House.
It is widely accepted that covid is here for the long term, which means we have to learn to live with it. As the Chancellor said so eloquently last week,
“we must learn to live with it, and live without fear.”—[Official Report, 24 September 2020; Vol. 680, c. 1155.]
We know that lockdown is not a cure. The restrictions give us temporary respite, but we are waking up now to the full cost of what that temporary respite means, not just in terms of livelihoods, jobs and people’s futures, but in terms of the suffering and sacrifice that so many have endured, in different ways. Long-term lockdown is not a solution; it is not living with covid. In many ways, it is hiding from covid and simply hoping it will go away. We know that there is much we can do to protect ourselves, our loved ones and our communities. We have seen the measures that shops, schools, pubs and restaurants take to stop the spread, and individually we have learnt to adjust our behaviour.
What we now need is a long-term strategy. It is a long-term problem and we have to approach it from first principles. We need a sense of perspective. The measures we introduce for the whole population need to be proportionate to the risk. Understandably, decision makers felt a sense of panic back in March, but now we know much more about this terrible virus. We know about the groups most affected. We know that the horrifying worst-case-scenario numbers we were given were never realised. so now we can be smarter and more targeted in our quest to prevent avoidable deaths. There is no need to impose indiscriminate, and sometimes arbitrary or capricious, restrictive measures on everyone.
This is a new virus, and the science is young. Unlike the scientists, the Government have to consider wider issues and not just the science. The Government have to consider not only the impact of lockdown on the economy and our health, but the social and moral consequences. They have to grapple with the big-picture issues such as the value of freedom, and to decide whether a covid death matters more than any other preventable death—I say it does not. The Government also have to bring the people with them. We all know which people are most in need of protection and we can understand why they need protection, but it is far less easy to understand why we are locking down students who can be safely exposed to the virus when we do not place similar restrictions on the people most at risk.
We need to understand risk and probability, and that robust, evidence-based data really matters. It is very uncomfortable being frightened to death by scientists presenting charts to the nation that they must know are wrong; that chart last Monday undermined public trust, as it was quite clearly pushing a worst-case scenario without telling us the probability of such a scenario occurring. Was it designed to instil fear in order to control the public? Is that how we want to govern?
Emergency powers were given to the Government when this was an emergency, and that was the right thing to do, but we all accept that we have moved on from there. I urge the Government to understand that we now need to involve Members of Parliament in this process in a different way from that which has happened so far. We may not be experts in science but we are experts in the people we represent. Day in, day out, we are engaging with our constituents, and their needs and concerns, and it is to our constituents that we owe a duty. I ask Ministers to allow MPs to bring that knowledge and expertise to bear, as I genuinely believe it would aid decision making.
I wish to end by thanking every member of this Government who have worked on this in recent months—they have my total admiration. It is not possible to get things right every time, and I applaud them for being so brave in keeping going despite the difficulties and challenges they have experienced. But I ask that they challenge the science with pragmatism and are not blinded by it; science is often as much about opinions as politics is, and we should never disregard the people we were sent here to serve.
(3 years, 11 months ago)
Commons ChamberThose are the challenges that we are working so hard to address. The message to the hon. Lady’s constituent and others is that there are thousands of tests available in her part of London, and it is incredibly important that those with symptoms come forward and those without symptoms—[Interruption.] I know that her constituent had symptoms. The critical thing is that all of us have the same message: those with symptoms do come forward, but those without do not. That huge spike in demand is the challenge. It is as simple as that.
Testing capacity is a finite resource, and it is right to consider prioritising care homes, hospitals and key workers. Will my right hon. Friend ask his Department also to consider the issue of testing very young children, who frequently experience raised temperatures, coughs and colds? Some parents are taking very young children for multiple tests, but those in that age group are unlikely to be out in the community spreading the virus. People want to do the right thing and nobody wants to overwhelm the system, so will he continue to do all he can to ensure that the testing system is operating efficiently?
Yes. I thank my hon. Friend for that question, which captures the challenges we face. It is absolutely true that children under the age of 16 are very unlikely to get ill with coronavirus; indeed, the proportion of under-16s testing positive is extremely low and is flat, whereas it is rising in many other age groups. She raises a clear point: the prioritisation we have is about getting the tests that we have—record capacity—to the people who need them most. That is why it is an important principle.
(3 years, 11 months ago)
Commons ChamberOf course, those who have been on furlough can reapply for furlough, and yesterday the Chief Secretary to the Treasury set out further support that is available for businesses in areas where we have had to intervene. The measures that we have taken in Bolton are strict but absolutely necessary, as I set out on Tuesday. I am grateful for the hon. Lady’s support for those measures and the discussions that we were able to have before they were introduced.
I thank my right hon. Friend for his statement and very much welcome the exciting progress on developing saliva testing. Outstanding progress has already been made on expanding testing capacity, and he deserves our thanks for his tireless work. Inevitably, this is not without its challenges. On Tuesday evening, hundreds of cars from across the country—and I do mean hundreds—descended on Telford’s testing site, as they were directed to do by the booking system. Tests quickly ran out, roads became blocked, people who had travelled from as far away as Cornwall, Stockport and London were turned away, and my constituents were no longer able to access tests in the area and so in turn were sent elsewhere. What assurances can he give that the error in the booking system that directed so many people to Telford has now been corrected, and does he agree that people should not be criss-crossing the country and travelling for many hours to secure a test?
(4 years, 6 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I must congratulate Jacqueline Dunkley-Bent, the chief midwifery officer at NHS Improvement—we are very lucky to have her. Compassion drives her, along with the absolute pursuit of excellent maternity standards. I know that there will be support for those families, and that NHS Improvement will also be reaching out to women who are pregnant and are due to go into the trust.
Let me say this, because I did not mention it in my original response. A number of measures are being taken in relation to the trust, which I probably cannot specify, but a written ministerial statement, which is in the House of Commons Library, gives the full list. I want Members to be reassured that those measures are thorough and robust, and they are working.
I thank the Minister for her excellent work and I hope that she does indeed continue in her present position.
Tragically, East Kent is not just a one-off; there seems to be a more widespread culture of denial throughout the NHS. We have seen that in the trust in my constituency. The management is saying, “It is historic, it is scare- mongering, it is just a few preventable deaths.” Does the Minister agree that if those in hospital management are to learn lessons, it is essential that that culture of denial is tackled and they recognise their shortcomings so that services improve?
As my hon. Friend knows, I have been to Shrewsbury and Telford Hospital NHS Trust to reassure myself—line by line—that every recommendation that was made by the Care Quality Commission has been implemented and is working. I thank her for raising this issue, but I also want to emphasise that Shrewsbury and Telford is a safe place for women to give birth, because the same robust approach is being taken there. It is a safe environment, and, as my hon. Friend will know, a new midwife-led unit will be opening shortly.
However, there is a culture that I know concerns the former Health Secretary, my right hon. Friend the Member for South West Surrey (Jeremy Hunt). In such circumstances, trusts do not feel able to put their arms around parents, to say sorry, to explain to them what has happened, and to show compassion or care. That culture must be broken, and I think that HSIB will go a long way towards contributing to the process.
(4 years, 6 months ago)
Commons ChamberI wish to speak to new clause 2, which is tabled in my name and those of my Liberal Democrat colleagues. As you know, Dame Rosie, I intended to push the new clause to a vote, but I understand that time pressures will not allow me to do so. I am disappointed by that, but I will be pressing the Government on this issue time and again. I want them to make it a high priority and to put it at the forefront of their policy making and commitments to the mental health of children and young people.
It is a pleasure to hear such a unified voice across the Committee about the importance of mental health, and there is a clear commitment to parity of esteem and to ensuring that mental health across the board gets the funding it deserves. I am therefore encouraged by the amendments, many of which I and my colleagues will support.
New clause 2 focuses specifically on the crisis—I used that word advisedly—in the provision of child and adolescent mental health services. It places a spotlight on the chronic underfunding of CAMHS, and seeks to encourage the Government and NHS England to deliver on their promises and improve transparency and accountability on those priorities.
Before I arrived in this place, I was aware of this significant and pressing issue. Less than two months since my election, however, I am utterly horrified by the cases of children and young people in crisis that cross my desk on a weekly basis—or more often—either through my surgery, my inbox, or anecdotally when speaking to acquaintances and contacts in my constituency and well beyond. New clause 2 seeks to make the Government and NHS England more accountable for the funding that they provide annually to CAMHS. That is very much in the spirit of the Bill. The Government are seeking to codify their promised expenditure on the NHS, and the new clause seeks simply to do the same thing in this important area, given that a number of welcome commitments have been made about CAMHS spending.
There are concerns that that funding is not reaching the frontline. Indeed, the evidence is clear. Just last week a report by the Children’s Commissioner stated that many CCGs are spending less than 1% of their mental health budget on children and young people. In 2017, the CQC revealed that CCGs have prioritised adult mental health over CAMHS because of the need to ration services. Other amendments seek to talk about mental health more broadly, but that is the reason why we need a particular spotlight on children and young people’s services.
The phrasing of new clause 2 seeks to ensure accountability against the ambitions of the long-term plan. Subsection (2) would help to demonstrate whether the promises on the growth of CAMHS spending outstripping mental health spending, and NHS spending across the board, are kept.
Subsection (3) shines a spotlight on regional variability. The Children’s Commissioner’s report last week talked about the enormous postcode lottery of spending on services. The numbers cited were staggering. In terms of low-level services, they ranged from 72p in some areas to £172 per child. On specialist services, they ranged from £14 to £191. We all expect some level of variation, but I am sure the Government would agree that that level of variation is utterly unacceptable. It needs to be tracked very publicly, so that spending and services can be improved to meet need.
Why is that so critical? As has been stated by various Members, half of all mental health problems are established by the age of 14. We know that 1.25 million children and young people had a mental health disorder in 2017. We have heard that since 2010 there has been an increase of 330% in admissions to A&E of children and young people diagnosed with a psychiatric condition. We know that only one in four children and young people is being seen by a specialist when they need to.
It is very easy to cite statistics, but behind them are individuals: children and young people and their stories. The stories I have heard are of teenagers self-harming, teenagers who are suicidal, teenagers who are a danger to themselves and their families, and young people who are excluded from school or are taking themselves out of school because of their mental health conditions. One piece of correspondence I received from a parent talked about her 17-year-old being referred for specialist treatment last November. He might be assessed, if he is lucky, in March and he will not get treatment for four to six months after that. That cannot be right. This child has at times been suicidal. I have also had a case of a 10-year-old with tier 3 needs waiting a similar amount of time for the initial choice assessment, who will be waiting a similar amount of time again for treatment.
We have had many plans, many vision documents and many strategies setting out wonderful lofty ambitions for the NHS. As I said, the long-term plan has some very laudable commitments on CAMHS. The Bill seeks to put into law what the Government promise on NHS spending. New clause 3 simply seeks to put into law the Government’s promises on spending on children and young people’s mental health disorders. I cannot press new clause 3 to a Division, but I very much hope that the Government will accept the spirit of my new clause and look to see what measures they can put in place to improve transparency and accountability. We owe it to those children and young people, because this really is a crisis and they need us to step up to the plate.
I will end my remarks with a quote from the mother of the 17-year-old I referred to earlier, because she puts it far better than I could:
“All these young people are our future and if we do not help them now, we are looking at a bleak future as these young people will end up being isolated from society, lack skills for work and relationships, find employment hard, perhaps even get into crime and ultimately will end up not having fulfilled lives and maybe end up being yet another statistic. We have not got this right and it is not just about the budgets or party politics; we need all of you to work together on this and treat this as an emergency.”
What a pleasure it has been to listen to so many excellent speeches. In particular, I want to say how much I value the contribution of the former Secretary of State for Health, my right hon. Friend the Member for South West Surrey (Jeremy Hunt)—I am sure that Ministers will have listened to what he said. I thank everybody who has tabled amendments, which are very thoughtful and well considered. I am particularly grateful for the amendment on patient safety, and again, I am sure that Ministers will have heard what has been said on that issue.
It is a pleasure to speak in a debate where we are not politicising something that matters so much to our constituents and where we are coming together to contribute our experiences, either in our constituencies or professionally. For that reason, I am delighted to be speaking.
I do not support the amendments, however well intentioned, well formulated and well thought out many of them are. However, I would like to speak to the amendment on capital budgets because there are some learning opportunities for the Government in how they spend significant capital investment on hospitals, upgrades and reconfigurations of hospital services. Those upgrades and reconfigurations are indeed happening now, as was set out in the manifesto, but they were also happening before that. My constituency and the county of Shropshire have experienced significant capital investment, but there has been a very difficult, painful and protracted process in trying to bring that forward as something that will benefit the whole community and improve patient care across the county.
I raise that issue because I hope that Ministers will take away from that experience the fact that it is fundamentally wrong to have significant capital investment where local communities are pitched against one another, as has happened in Shropshire. We saw local CCGs propose that Telford should lose all its acute services and be stripped of its A&E and women and children’s services, with them being transferred to another community some 20 miles away that is significantly more affluent and has better health outcomes. In addition, it was intended that that community would also receive £312 million of capital investment in new facilities. I am sure that hon. Members can imagine how that would make our community feel, particularly when it is disadvantaged in many respects. It is a growing new town that will have 200,000 residents in the next 10 years. We have to provide services with equal access for all, because as this Government have said, they are about one thing: levelling up. They are about narrowing health inequalities and ensuring that there is equality of access to health services across our communities. Of course, the NHS has always been about need. Funding in the NHS should follow need.
I will not delay the House too much with further discussion of the situation in my constituency because I believe that my CCGs, after six years of debating this issue, have had another thought about how they might resolve the problem. It will require more Government funding, but they have already made it clear that the proposal that is currently on the table will also require more Government funding. It will provide a fantastic opportunity for us to resolve this situation, which has been ongoing for so long. So, if the Minister is listening to pleas for more capital funding, may I ask that we complete the proposal in Telford, which will be of such value to our community?
There are other learning points that come from the capital investment programme. CCGs and health trusts have a duty—indeed, the Secretary of State has a statutory duty—to narrow health inequalities. We see that across the country where there have been controversial reconfigurations of local hospital trusts and hospital builds. It is not just in Shropshire either; many MPs on both sides of the House have spoken of the need to narrow health inequalities and to ensure that more affluent communities do not benefit at the expense of more disadvantaged ones. This new Government could not tolerate that continuing in areas of disadvantage.
(4 years, 6 months ago)
Commons ChamberI am totally with the hon. Lady, and as a nurse myself, I know that that happens with senior nurses, not only senior doctors, because there is the same culture of fear, and of not wanting to challenge a superior who is more experienced in what they are doing. Such a change cannot happen overnight. It will take time, but I think it is already happening as a result of increased confidence. We have recently had a few inquiries, and I think patients now have more confidence to speak out. Under the national guardians scheme, whistleblowers have more confidence to speak out. I think that cultural change is happening, and last week I visited a hospital where I saw that in process.
Our job is to ensure that we introduce whatever needs to be put in place. No one is God. When I trained as a nurse, doctors were like God, but that is not true; that is not the case. This has been a long road, and we need to challenge that culture even further. Those who have been practising for some time are esteemed, and we value their experience. We value those people, but we must also break the culture that means they are not to be challenged. Making the revalidation and appraisal system more robust is one way to do that.
I thank the Minister for her heartfelt apology for what has happened, and for her commitment to patient safety. Does she agree that there are clear commonalities between this case and other tragedies, such as those at Morecambe Bay and Shrewsbury and Telford Hospital NHS Trust? As the hon. Member for Central Ayrshire (Dr Whitford) said, there is an imbalance of power between male consultants, and in this case female patients, who often just accept what they are told by a more powerful figure.
This day is about the victims of Paterson and the women he treated, and I do not want to detract from that by going down another road and talking about another inquiry. My hon. Friend is right: often women are those most affected by these issues, which is why I spoke about the importance of consent. We as a Department must consider how such consent is gained, and I think the Cumberlege report, which we are expecting to come to Parliament soon, will help with that.
(4 years, 7 months ago)
Commons ChamberI am delighted to have been granted this Adjournment debate on this very important issue. I want to raise it because the issue deserves the platform that Parliament affords. It concerns the safety of women and babies receiving maternity care at hospitals in Shropshire. I raise that in the context of the Morecambe Bay trust inquiry into maternity deaths in 2015, which at the time was considered to be a one-off. What has come to light at Shrewsbury and Telford Hospital NHS Trust suggests that there may be systemic problems within the NHS and maternity care, and there are without doubt significant concerns about the lack of transparency and openness around what went wrong.
The Ockenden review was set up two and half years ago to look at 23 possible cases of maternity malpractice at the Shrewsbury and Telford Hospital Trust. So far there have been no formal published findings. However, in November 2019 interim findings were leaked to the media. Those findings show not only that had some very serious failings indeed been uncovered by the review, but that the scale of the malpractice, and the number of women and babies affected by it, exceeded anything that had been expected when the review was initiated.
The interim findings stated that there had been in excess of 40 avoidable maternity deaths and 50 brain-injured babies. NHS Improvement was given that information almost a year ago and appears to have kept quiet about the findings. The findings also make reference to “widespread failings, a toxic culture and a failure to learn lessons.” Since those findings were made public, many, many more women have come forward—women who knew nothing about a review being held. The review is now looking at over 600 cases of possible maternity care malpractice.
Those interim findings directly contradict what senior management were saying publicly at the time when the review was commissioned. Senior management claimed that this was all overblown by the media, that it was all historical, and that good practice was in place now. The chief executive claimed that concerns raised about the possible scale of malpractice were “scaremongering”—his word. Senior hospital management adopted the stance that “it simply couldn’t happen here.” The CEO said that the media, particularly the BBC, had it in for them; that is what they actually said to me, the MP. How, in that kind of environment, can lessons be learned if there is no acceptance that anything has gone wrong?
We had the same response from the authorities in Telford when the scale of child sexual exploitation in the town was revealed. That denial, or perhaps being in denial, seems to be the standard response from those in positions of authority—minimising the problem, blaming the media and depicting those affected as being in some way troublesome.
Let us compare the review from Shrewsbury and Telford Hospital NHS Trust with that from Morecambe Bay, where there were 11 avoidable baby deaths and one maternal death. The Morecambe Bay inquiry reported promptly, and the then Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), came immediately to the House, made a statement, and apologised to the families. He pledged that lessons would be learned, and that the legacy of those tragic deaths would mean that such things could not happen again. My right hon. Friend is in the Chamber today, and I am grateful that he did not just accept the position taken by senior management, NHS bureaucrats, and officials from Shrewsbury and Telford NHS Hospital Trust at face value. I commend him for initiating the Ockenden review, and for his commitment to encouraging a culture of transparency and openness across the NHS. We must continue with that approach.
I wish to repay the compliment and thank my hon. Friend for her tireless campaigning on this issue. It is not easy publicly to criticise a local hospital trust, and for an hon. Member to do that, as in this case, shows enormous courage. Does she agree that the biggest mistake the Government could make when they publish and respond to the Ockenden review would be to say that this is a one-off incident? The most important thing is to consider what went wrong at Shrewsbury and Telford, and to learn those lessons for the whole NHS. The big thing that we learned from Morecambe Bay and Mid Staffs was that such lessons apply across the system.
My right hon. Friend makes an important point—I was going to come to it in my speech, so I will bring it in now. The Morecambe Bay inquiry was led by Dr Bill Kirkup, who said of the recent findings at Shrewsbury and Telford Hospital NHS Trust that
“two clinical organisational failures are not two one offs”,
and that that points to an “underlying systemic problem” that may exist in other hospitals. My right hon. Friend is right to make that point, and I thank him for his kind comments.
The interim findings in the Ockenden review were not published, and I understand that the hospital trust has not been told about them. The families were certainly not told about them, and neither were MPs. There has been no statement to the House, and we do not know what action is being taken to ensure the safety of women and babies at Shrewsbury and Telford Hospital NHS Trust.
I am an avid watcher of that Sunday night programme, “Call the Midwife”—I am not sure whether you watch it, Mr Speaker—where everything seems to work out at the end of the day. The hon. Lady is outlining something that does not work out at the end of the day. She mentioned families. Does she agree that the care of mother and baby must be a priority, and that more support for mothers who have had several children must be considered, to ensure that they are coping and not expected simply to carry on because they already know what to expect? Every life is precious and adds more pressures to families, particularly mothers.
I very much appreciate the hon. Gentleman’s intervention. As always, he makes an excellent point, and I am grateful to him for his many interventions in many debates I have secured.
I am concerned that the NHS can choose to sit on this information, and that Ministers can say, “Well, we don’t comment on leaks”. This is about the safety of women and babies, and the adequacy of the maternity care they receive in our hospitals today. Women were repeatedly told that their case was a one-off tragedy, that there will always be risks to childbirth, and that such risks cannot be completely mitigated. Failings seem somehow to have been normalised, and at the time many women accepted that, rather than question or challenge the care they received. People trust the medical profession, which is why openness and transparency are so crucial.
When people raised concerns they were dismissed as being difficult—no one listened. There was a “we know best” attitude, and complaints about poor practice were treated as women making a fuss about a perfectly natural event that occasionally would have a negative outcome. As Health Secretary, my right hon. Friend spoke about “never events”, and I suggest that those must include an avoidable death. A baby dying in childbirth should therefore be a “never event”, yet it seems that that is not the way the deaths in this case were treated—they were treated as something that could be a result of childbirth. The trust even boasted of having the lowest number of caesarean deliveries in the country, so there seems to have been an unwillingness to intervene when there were complications in a delivery. In my view, an intervention during a difficult birth must be a good thing: that is what the clinicians and medical professionals are there to do. I am concerned about the way this trust appears to have treated women and about its attitude towards women, which seems to have been dismissive. And that is something we have seen from the top.
What adds insult to injury in this particular case is that the trust commissioned a report in 2013 that appeared to find that all was well. We now know, because of the leaked report, that that was in fact a whitewash. The trust was exonerated by what was a perfunctory bare minimum desk-top review. This allowed poor practice to continue unchecked. If it had been identified at the time, the more recent cases of malpractice, which are still coming forward and include death and injury, could have been avoided. We still do not know how many women and babies have been affected, but we do know that £50 million in compensation has been paid out already. However, with hundreds more women coming forward, the cases in which a financial settlement has already been reached are clearly the tip of the iceberg.
The question we have to ask, and must go on asking, is whether that poor care, and the normalisation and denial of it, is a systemic problem within the complex bureaucracy that is the NHS.
I shall be delighted to give way to my right hon. Friend and constituency neighbour.
I congratulate my hon. Friend on bringing this very, very difficult subject forward. I also thank my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for launching the Ockenden review. It is very easy to talk about numbers, but every one of these cases is unutterably terrible and ghastly for the family concerned, and obviously a total tragedy. We all know dreadful stories from the past. The latest figures show that the infant mortality rate at Shrewsbury and Telford Hospital Trust is 3.7 per 1,000, against a national average of 3.9 and a national target, which I would like the Minister to comment on, of 2.6 by 2025. My hon. Friend has rightly raised the absolute horrors and the dreadful culture—we all know terrible stories—but does she derive any satisfaction from the fact that we are marginally better than the national average at the moment and possibly heading towards the national target by 2025?
My right hon. Friend makes a very important point. Clearly, the majority of women using these services have an excellent and safe experience. It is good news that there is progress and improvement, but we should not gloss over any of these cases. Regrettably, there have been new, recent cases in my constituency where women have come forward, having been made aware of the review, saying, “This happened to me a couple of years ago.” It is good that the numbers are improving, but we must make sure that every one of those deaths is treated as another event.
I am most grateful to my hon. Friend. I completely agree with my constituency neighbour, my right hon. Friend the Member for North Shropshire (Mr Paterson), that she is making a powerful case. It is quite right that she has brought this issue forward. On the subject of current practice versus some of the cases that are being considered in the Ockenden review, which stretches back 40 years, she will remember that it was initiated by the case of a couple who were constituents of mine. They lost their baby in 2009, over 10 years ago. Their concern was that, as my hon. Friend rightly identifies, the case had been inadequately handled and effectively covered up by the hospital.
One of my concerns, in addition to getting to the bottom of what has happened over a long period of time, is that we need to be reassured, as local Members of Parliament serving our constituents today, that the maternity services available to people in Shropshire are safe and of high quality. It would be helpful if in some way, given the scale of the inquiry that Ockenden is undertaking, there could be some interim finding on the current state of practice in Shropshire and Telford, so that at least expectant mums who are going to use those services can feel reassured. That would not prevent a more detailed inquiry going back into past practice. Does she agree with me on that point?
My right hon. Friend makes an excellent point. That might be something that the Minister can address, because we want users of maternity services to have absolute confidence in the care that they receive. However, we do not create confidence by hiding facts. If we can get some of the facts out that have been leaked to the media, let us do that and deal with those. He is absolutely right that that will help to reassure parents and give them confidence in the services that are being delivered—the vast majority receive a very good standard of care, and safe care.
The trust, and possibly other trusts, must work towards a culture of openness and transparency and perhaps show more of a willingness to accept that, “This can happen here.” I kept hearing, “Well, this can’t happen here. It hasn’t happened here,” and I cannot feel comfortable if people cannot acknowledge where things have gone wrong.
I recognise that the Minister may not have all the answers today, and I do not expect all the points to be addressed, but we need to know why NHS Improvement sat on the review’s findings for almost a year. Given how serious they are, why has it not come forward to say, “This is what the Ockenden review has found at an interim stage”?
I want to ask who knew what and when. Were Ministers informed, or were they too kept in the dark? If this had not been leaked, when would we have been told? When will the review be completed? It has now been almost three years. When will the Secretary of State make a statement on this very, very serious issue? I also want to know whether the management still think that this has been cooked up by the media, or whether they genuinely now realise that there is a serious problem to be addressed. It is very important that the Department of Health and Social Care and NHS bodies understand and acknowledge the seriousness, and that all parties are encouraged to be open about it.
As a constituency MP who has had women contact me recently to share their birth experiences at the trust, it seems to me that red lights are flashing. We need to know what is being done to ensure the safety of women and their babies using this service. I very much thank the Minister for her forthcoming comments and any reassurances that she can give my constituents on this issue.
(4 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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I beg to move,
That this House has considered Princess Royal Hospital, Telford.
It is a great pleasure to serve under your chairmanship, Mr Betts. Last week the Leader of the House, my right hon. Friend the Member for North East Somerset (Mr Rees-Mogg), said:
“Our main purpose as Members of Parliament is to seek redress of grievance for our constituents”.—[Official Report, 31 October 2019; Vol. 667, c. 509.]
That is what I seek to do today, on the last day of this Parliament and on what might be my last opportunity to speak for Telford. It is a great privilege to have the opportunity to do so.
For the past six years, Telford’s No. 1 concern has been the future of the Princess Royal Hospital. Throughout those years, I have been working with my community to get their concerns heard by the hospital management and in many debates and speeches in this place. Today is different, because in the past few weeks the Secretary of State for Health and Social Care endorsed a decision by hospital management to proceed with a plan that will mean Telford loses vital hospital services and that, simultaneously, will lead to huge investment in Royal Shrewsbury Hospital in the county town of Shrewsbury, some 30 minutes away from Telford. In this debate, I want to put on the record why my constituents feel a sense of loss and a sense of anger.
Telford is not a place that has a sense of entitlement. It is not a place that makes demands or shouts over the voices of others. It is a stoical place and has often had to overcome the odds, face adversity and keep on going. It is a former mining town and is now a rapidly growing new town, lying 20 minutes equidistant between Black Country Wolverhampton and the leafy county town of Shrewsbury. Telford is remote and isolated, because it has poor transport connections and low car ownership. It troubles me that, despite the poorer health outcomes, child poverty and health inequalities that I as the MP see, the hospital management has brought forward a plan for our health that allocates NHS resource not in accordance with need, but for some other reason that has not been explained.
Like many new towns, Telford was resisted by its county neighbours when it first came into being some 50 years ago. It was dismissed as an overspill town of incomers and a blot on the landscape, never quite accepted by its rural hinterland. It was somehow always the poor relation, surrounded by rural, leafy shires and county towns. There was a snobbishness whereby Telford was supposed to know its place and be grateful for the opportunity. We were somehow never quite equal to our neighbours.
However, Telford has ambitions, and overcoming the odds is what it does. Today, Telford is an economic powerhouse of advanced manufacturing and makes a massive contribution to the west midlands economy, offering new jobs and homes. Its population is forecast to grow to 200,000 people in the next 10 years. Telford needs its A&E and its women and children’s centre—anyone who knows Telford knows that—but the hospital management has other plans.
For six years, the management has toyed with a plan to centralise services 30 minutes away. It has been dressed up as local decision making by local clinicians, but, in reality, it was decided by executives from across the country—smart suits and smart cars—with no connection to our area and no concern for our communities. Indeed, the original architect of the plan held many hospital management chief executive officer posts, from Chester and Sherwood Forest to London, and he was last reported to be earning £40,000 per month, having resigned from a previous post for a single day in order to pick up a tax-free retirement package of £252,000 and then resumed the same job the next day. Such are the people behind this plan.
Actual local clinicians opposed the plan, as did all the councillors and local MPs. Protests were held and petitions made, but the decision makers did not want to know what local people had to say. Throughout that time, there was one hope—that once the bureaucrats got to the end of their decision-making process, the Secretary of State for Health and Social Care would call for an independent review to consider all the issues. I thank the former Secretary of State, my right hon. Friend the Member for South West Surrey (Mr Hunt), for his courtesy, consideration and kindness to me and my constituents as he listened to me and to the arguments about why the plan is flawed.
The hospital bureaucrats, whose decision this was, did not have to think about how people feel when they are told they do not need their A&E. It is not part of their role to understand our communities, our history, our geography, our identity, our emotional connectedness to our hospital, our affection for it and our pride in it. After all, they are not accountable to us; it is just one more job before the next one.
We, the representatives of the people, should care about our communities. We should care about how they feel, and about their sense of what is just. It is our job to be on the side of the people—not on the side of those who are well connected and have power and influence, who can speak to the decision makers behind closed doors, but on the side of the stoical, decent people of Telford, who play by the rules and have a right to be treated as fairly and justly as anyone else.
I will quote a constituent who has worked locally in the NHS for 15 years. He says:
“In Telford we are a group of hardworking communities with ambitions for our children’s future. When the brand new women and children’s unit was opened I was ecstatic. It was a turning point for us. I understand how health economics works—none of this proposal makes any sense, not in a business sense nor from a clinical outcome perspective. Shrewsbury is 30 minutes away. That’s too long for stroke, too long for a heart attack and too long for our children. This is a plan that bears all the hallmarks of cronyism at its rampant best. How else can it be explained? The NHS has no colours or banners”—
he is right about that—
“it supports all of us all of the time. It is something worth fighting for, for our children’s sake.”
On the point about children, I want to give voice to another one of my constituents. She wrote to me and said:
“My name is Sarah. I live in Telford. I am a mother to Alfie, who is 5 years old. Alfie has Down’s syndrome. In April 2018, at night, our son began to haemorrhage and he was taken to Telford A&E. Whilst there Alfie started to have a massive haemorrhage (blood was pouring from his mouth and nose and you could not even see his face or his beautiful blond hair). I was immediately told to run with him to Resus. There was so much blood. He was rushed in for an emergency operation to cauterise the bleed. Then our world then truly fell apart. He failed to breathe in air, post surgery. It took the theatre staff three hours to get him stable. The point of telling you this is quite simple. If A&E at PRH had been closed, Alfie would have had his 2nd and massive haemorrhage whilst still being transported to wherever they deemed to take us. I have chills just thinking of what the outcome would have been for our beautiful son. Put simply, having A&E open 24/7 saved Alfie’s life.”
I know the Secretary of State has tried his best to save our A&E from the hospital management’s plan. Indeed, he announced on the Conservative MPs’ WhatsApp group last week:
“Lucy, we’ve saved the A&E at Telford. We have just put a further £5 million into Telford’s hospital just last week.”
That would clearly be fantastic news. If it were indeed the case, I would not be standing here today; I would be writing an election leaflet proclaiming the good news to my constituents. Let us not be flippant and casual about something that is so important. My constituents want to know what an A&E local is and, importantly, whether the hospital management will agree to support it. When I asked the Minster’s parliamentary aide, my hon. Friend the Member for Chichester (Gillian Keegan), whether she could find out more about A&E local, she asked her assistant to respond to me. They said that my inquiry would be passed on to the Department for a response, which, in the light of the impending dissolution of Parliament, would not come until after Christmas at the earliest, in 2020.
It was the Minister’s decision to rush out an announcement in support of the management’s plan. He chose to do so without having worked out what would happen in Telford. Having made that announcement of his own volition, it is not good enough to say, “You’ll just have to wait to find out more.” How do I explain that to my constituents? If the funding for a new 20-bed ward for winter pressures has increased from £4 million to £5 million, that is fantastic, but I want to know and be able to tell my constituents about that. Simply mentioning it in a WhatsApp group is not enough; something has gone wrong with the communication.
My mission as an MP is to stand up for my constituents and take up their needs and concerns, so I know that the Minister will fully understand why I am so aggrieved that my constituents have been treated this way. Their treatment has been shabby and disrespectful. We are talking about the issue that matters most to my constituents, which is why I have helped them to crowdfund the money and seek counsel’s opinion on whether to pursue judicial review. We have nearly hit our target—thank you Telford—but it should not have come to this. A little more respect for the people of Telford would have avoided this situation.
During this lengthy saga, a former hospitals Minister—not my right hon. Friend the Member for Ludlow (Mr Dunne), who is here today—said to me, “They can’t all expect to have an A&E at the end of their road you know, Lucy.” My constituents have never asked for that and nor would they. They ask only to be treated as equal to anyone else in their value, worth and dignity, and that is what they deserve.
My right hon. Friend is one of my dearest friends and I would be delighted to give way.
My hon. Friend and neighbour makes a powerful case, as she always does when standing up for her constituents in the House. She has given some very moving examples of the messages that she receives and of the strength of feeling in the community that she serves. Does she recognise that the debate on acute services provision in Shropshire and Telford—that is the wider area, which extends to mid-Wales—has been ongoing for decades? In all the time that I have been a Member of Parliament, the difficulty arising from indecision about the reconfiguration of acute services has led to many services being provided out of county.
My hon. Friend mentioned stroke and cardiac services. Many of those are now provided in Staffordshire, so Shropshire has already lost services and people have to make long journeys. A reason for that is the difficulty in persuading enough clinicians with sufficient seniority and experience to provide a safe 24/7 service for our constituents. Although I completely understand her regret—half of my constituents would prefer to see the Telford services remain where they are—does she not see the opportunity to resolve the crisis and to ensure that we retain quality services for our combined populations? The area that she has focused—
As a former hospitals Minister and long-serving Member of Parliament for the area, my right hon. Friend has a great level of expertise on this subject. He makes some excellent points, some of which I agree with. We are very fortunate that £312 million of Government money is being invested in the area, but I want my constituents to benefit from that, which is why we are having this debate.
If I return to Parliament after 12 December—I suspect the Secretary of State would rather I did not—I will do all I can to ensure that my constituents are treated better than they have been until now. As suggested by the Leader of the House, I will seek redress of grievance for my constituents, whether in Parliament or by working with them to challenge the decision in the courts.
I thank my hon. Friend the Member for Telford (Lucy Allan) and congratulate her on securing this important debate. As ever, she spoke on behalf of her constituents with passion and determination. She and I entered the House on the same day in 2015, and I would be mortified if she did not return after the election, although I suspect she will. I know that the Secretary of State for Health and Social Care, to whom she referred throughout her speech, would share my sentiments and wish for her to return to the House because she is an exemplary Member of Parliament, even though, on occasion, she may press us to go further when she is speaking up for her constituents.
I echo the spirit of my hon. Friend’s speech by thanking everybody who works in our amazing NHS for everything they do, particularly those who work in her local hospital in Telford. I know that there are strong feelings on all sides of this debate, but whatever the differences of view, everyone involved—particularly my hon. Friend—wants to do the right thing for patients.
As hon. Members will know, major service change in the NHS is complex. My right hon. Friend the Member for Ludlow (Mr Dunne), a distinguished former Minister of State for Health, knows that only too well and alluded to it in his remarks. Major service change involves a number of factors, and it is vital that the voices of local people and their MPs, including my hon. Friend the Member for Telford, are heard and respected at all stages. I am grateful for the opportunity to provide a brief overview of the plans and to update my hon. Friend on our progress in recent days.
My hon. Friend mentioned the Future Fit plans. The set of proposals that fall under that heading have been under development for a number of years. The case for change was first articulated about 10 years ago, and the clinically driven scheme proposed to transform services across Royal Shrewsbury Hospital and Princess Royal Hospital. A 15-week consultation on those proposals ran in summer 2018.
The joint committee of the Shropshire and Telford and Wrekin clinical commissioning groups decided to proceed with the preferred option of the local Future Fit programme. That programme would see the Princess Royal Hospital in Telford become a dedicated planned care site and the Royal Shrewsbury Hospital become a specialist emergency care site. Under those proposals, patients would continue to be able to access 24-hour urgent care services at both hospitals, meaning that 80% of patients would continue to go to the same hospital for emergency and urgent care. The model would also see women and children’s consultant-led in-patient services provided at the Royal Shrewsbury in the future.
As has been alluded to, in March this year Telford and Wrekin Council referred the scheme to the Secretary of State, who in turn referred it to the Independent Reconfiguration Panel, which then provided its advice to the Department on 31 July.
Turning to the crux of my hon. Friend’s concerns about the A&E and urgent and emergency care, she is right that all patients should receive excellent healthcare throughout their life, no matter where they live. Any changes to services are rightly based on clinically led decisions at the local level. I am delighted that, as she mentioned, we are investing £312 million to support acute services in the local area.
The Secretary of State, following thorough consideration, accepted the IRP’s impartial advice, which looked at urgent and emergency care across Shrewsbury and Telford, and recommended that the emergency care centre for the region should remain at the Royal Shrewsbury. My hon. Friend the Member for Telford has been courteous but clear about disagreeing with that advice, on behalf of her constituents.
The Secretary of State also asked NHS England to come forward with proposals within a month on how to keep the A&E in Telford open as an A&E local, to ensure that the Princess Royal Hospital can continue to deliver the urgent and emergency care that the residents of my hon. Friend’s constituency need and value so much. That request drew on the advice provided by the IRP. Plans for A&E locals are being developed by NHS England and NHS Improvement, and the Department has been in close contact about those developments.
NHS England has now published the proposal, following the Secretary of State’s request. He and I are delighted with the development. The Shrewsbury and Telford trust has put forward a model that will enable an enhanced service that is distinct from an urgent treatment centre. The model will increase the volume of activity that can safely be delivered through the proposed urgent treatment centre on the planned care site at PRH.
I understand that the Secretary of State and NHS England have today written to my hon. Friend the Member for Telford. If I may, I will touch on what that letter says. She may well wish to come back on it, once I have let her know what it states. The Secretary of State has been clear: the A&E at the Princess Royal Hospital, Telford, will remain open as an A&E local.
In my constituency, there is concern as to what “A&E local” means. I am aware that there is 24/7 walk-in, which is fantastic, although most of my constituents do not know that, but will “A&E local” be defined in more detail? I have not yet received the letter, so will the Minister enlighten me and my constituents?
I am happy to do so. I hope that what I say will be helpful to my hon. Friend, but I am always happy to have a further conversation, if she so wishes after this debate. If she and I are both successfully returned to this place and doing the same things, I would be delighted to meet her.
The trust and local commissioners will further develop a framework of options for outside core hours. The trust has proposed a model that will increase the volume of activity that can safely be delivered through the proposed UTC on the planned care site. It proposes an emergency medicine consultant presence throughout core hours, a consultant-led ambulatory emergency care service for specific pathways, and additional diagnostic presence. That model means that the PRH will continue to provide A&E services. We are satisfied that that meets the proposed A&E local model.
My hon. Friend will wish to consider that further, and she may wish to have a further conversation with me, but I believe that the proposal is testament to the strong voice that Telford has because she listens to her constituents. It is a victory for my hon. Friend in speaking up for her constituents.
I am very grateful indeed to hear the Minister’s comments and, in particular, to see some movement—a shift indicating that we are being listened to and that Telford is not being ignored. I am grateful for that development and progress. As the Minister will understand, I may well continue to push for further progress, but it is a step in the right direction and I am grateful for it.
I am grateful. It would be a brave Minister who ignored either Telford or my hon. Friend, and I am not sure that I am quite that brave.
I believe that this is welcome news, although I know that my hon. Friend will want to consider and digest it. It also comes on top of the extra £4 million in winter capital funding going to the PRH—again, she argued for that and helped to secure it—which the Secretary of State announced last week, to reduce pressure on the A&E and to prepare for winter.
Will the Minister confirm that that winter capital funding is for this winter and an extra 20-bed ward?
I confirm that that is capital funding for her hospital to prepare for this winter and to meet the challenges it faces.
The detail of the proposal has still to be worked up, and NHS England will work with the trust, its partners and the Royal College of Emergency Medicine to support the development of the model and a timeline for its implementation. I hope my hon. Friend wishes to be involved in that process, and that both of us will be back here to have that conversation later in the year.